Project Summary Abstract The Upstate Carolina Consortium NCI Community Oncology Research Program (NCORP) integrates 3 affiliates who together have a well-established history of NCI research participation: Community Clinical Oncology Program (CCOP) 1983 to 2014 and NCORP 2014 to present. Upstate Carolina Consortium NCORP has 48 experienced and engaged community investigators led by 3 qualified Principal Investigators, 1 medical oncologist and 2 radiation oncologists, with early, mid to senior levels of experience. The 3 affiliate research programs are located within community hospitals serving the upstate of South Carolina and adjacent areas of North Carolina and Georgia. Upstate Carolina Consortium NCORP serves a socioeconomically challenged area with a 35% rural population, aging demographic, and 29% minority population. These populations have longstanding disparities in cancer outcomes which will be addressed by this project. The project goal is to reduce cancer incidence, morbitiy and mortality by accelerating the adoption of research advances into community practices through participation of community oncologists, non- oncology specialists, and primary care physicians in NCI clinical trials. The specific aims are to: 1) Achieve over 400 annual accruals across treatment, cancer control, prevention, and quality of life studies; 2) Conduct and support the design of Cancer Care Delivery Research that impacts patient outcomes, practitioners, and health care delivery systems; 3) Ensure capacity to screen and enroll to NCI Precision Medicine trials which bring novel agents and hope to cancer patients with limited treatment options; 4) Enhance screening and access to clinical trials for Adolescent and Young-Adult populations; 5) Promote the participation of African American and other underrepresented groups in our catchment area to NCI Clinical Trials through community engagement; 6) Ensure high quality clinical research data to support acceleration of cancer discovery; 7) Support Investigators and Clinical Research Professionals training to ensure effective clinical research and patient centered engagement; 8) Protect human subjects through compliance with a rigorous regulatory structure and quality assurance program. The consortium has the experience, capacity, institutional support and expertise to achieve the project goal and stated aims.